Throughout my life, I have never had to worry about basic provisions: shelter, means or health. This is because I was fortunate enough to be born into a middle-income family. For homeless communities, it is the exact opposite. In addition to concerns about having enough food to sustain them for a day, they face dilemmas regarding health, safety and other issues that I would not know of.
Now, there is a sporadic hepatitis A epidemic affecting people across California. The California Department of Public Health, or CDPH, has noted that this epidemic is the largest person-to-person (without a joint source) outbreak to affect California since the introduction of the hepatitis A vaccine in 1996.
At first, I thought little of hepatitis A. If I had known that it can lead to deaths, I would not have let this issue slip over my head. As of Jan. 26, 2018, the CDPH has reported 689 incidences of and 21 deaths from the current hepatitis A outbreak. The paths of transmission for the hepatitis A virus are through intake of contaminated food and water or direct contact with an affected person.
The first path is very applicable to all Berkeley residents, as the virus is a vector in water that has been contaminated by feces. In other words, all public places with water — including restrooms or drinking fountains — have a possibility of carrying the waterborne virus. Furthermore, the hepatitis A virus can survive sanitation methods used in food plants, so packaged foods may become unsafe.
Physical contact with infected people is also dangerous, since symptoms of hepatitis A appear after an incubation period of approximately two to four weeks. Because infected people are asymptomatic carriers for about 10 days, they are practically indiscernible as hepatitis A carriers to whomever they interact with.
The homeless community of Berkeley is especially at risk, as the populations experiencing the most instances of hepatitis A virus are homeless people and users of illicit drugs. The conditions of homeless encampments are breeding grounds for hepatitis A — they have all the necessary elements needed to facilitate disease: lack of access to safe drinking water, recreational drug use, crude sanitation (for sewage and hygiene) and proximity to other vulnerable people.
As the majority of the infected population is homeless, the most effective way to target the hepatitis A outbreak is to stem the problem at its root by preventing the virus from transmitting. In all outbreaks, prevention is more effective than treatment. Rather than attempting to track down the sources of contamination in the entire city of Berkeley after cases of hepatitis A, it makes more sense to initiate the Berkeley Homeless Commission’s proposed preventative measures: providing port-a-potties, handwashing stations, free hepatitis A vaccinations and trash removal services, especially in areas highly populated by the homeless. By specifically aiding the homeless population, the amount of hepatitis A carriers will be reduced, and, in turn, fewer people will be affected by hepatitis A-contaminated vectors or infected people.
Although residents of Berkeley may believe this outbreak would have no impact on them, I beg to differ. No person is completely safe without the hepatitis A vaccine. To make matters worse, students at UC Berkeley and other California public schools are yet to be legally required to receive hepatitis A vaccines. If more people in the Berkeley community are affected by hepatitis A, there will be a noticeable toll in all levels. Since a treatment for hepatitis A does not exist, patients may have symptoms for months until recuperation. Affected students may miss their midterm examinations, affected workers may lose more wages than they can afford, and people seeking help from services may be held up in wait lines.
Another argument that Berkeley residents may take is that hepatitis A vaccines are very accessible, so few people would be infected. This is true: The Berkeley Free Clinic and the City of Berkeley Public Health Clinic offer free hepatitis A vaccinations. I argue, however, that many people are not aware of the severity of this outbreak in terms of lethality and contagiousness. It is simply not safe to assume that all the citizens of Berkeley are as well-informed of this epidemic and vaccination centers as they must be (I admit, I knew very little until conducting online research, as well).
Most importantly, I see access to public sanitation facilities as a basic human right that the government has accountability for. Homeless people live drastically different lives from people with homes, but we all share a vital trait: We are all humans. From my perspective, it is a human rights violation to ignore fellow humans, especially when we are aware of a disease outbreak amid the homeless population around the state.
The hepatitis A epidemic is not a problem for the homeless; it is a problem for Berkeley and California as a whole. As a member of the Berkeley community, it is important to get vaccinated as soon as possible, and to inform others — homeless or not — to do so as well.